Title:Bowel Damage Assessment in Crohn’s Disease by Magnetic Resonance Imaging
VOLUME: 13 ISSUE: 10
Author(s):Gionata Fiorino, Laurent Peyrin-Biroulet and Silvio Danese
Affiliation:IBD Center, Gastroenterology, IRCCS Humanitas, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
Keywords:Crohn’s disease, damage, inflammatory bowel disease, magnetic resonance imaging, score, Strictures, fistulas, abscesses, colonoscopy, symptom-driven approach.
Abstract:Crohn’s disease leads to complications in the majority of patients on the long term. Strictures, fistulas and abscesses
usually involve the bowel wall or extra-intestinal compartments, and conventional diagnostic tools, such as
colonoscopy or barium studies, are not able to assess them. Magnetic resonance imaging has been proven to be accurate in
detecting activity, severity and complications of Crohn’s disease. Because of its reproducibility and safety, it can be considered
the first-choice technique to complete Crohn’s disease staging, and to monitor disease evolution. Recently, the
concept of bowel damage has risen into the field of inflammatory bowel diseases. It has been shown that bowel damage
induced by the disease can impact on patients’ life, beyond intestinal symptoms. Data coming from rheumatology suggest
that blockade of organ damage should be achieved independently from disease-related symptoms, and that a “damage
driven” approach should be preferred than a “symptom-driven” one. This review of the literature aims to investigate the
role of magnetic resonance imaging in assessing disease complications, which cause organ damage, and to explore future
perspective in order to develop new therapeutical strategies and new tailored therapies, based on the prevention of intestinal
damage.
